We carried out this comprehensive inspection between 26 and 28 August 2025. Great Prospects Care Ltd is an independent domiciliary care agency providing personal care and support to 42 people in their own homes, and a supported living service for 5 people with a learning disability and / or Autistic people. ‘Right Support, right care, right culture’ (RSRCRC) is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people, and providers must have regard to it. We have assessed the service against ‘Right Support, right care, right culture’ (RSRCRC) guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. At our last inspection, we found breaches of legal regulations relating to safe care and treatment and good governance. This inspection was carried out to see if the provider had improved in the way they told us they had, and to determine whether the provider remained in breach of these regulations or not. We found a marked change in the quality of care provided by Great Prospects Care which had resulted in a positive impact on people, staff and an improved culture. The provider demonstrated that improvements had been made, and therefore, following this inspection, the service is no longer rated as requires improvement overall or in any of the key areas. People were protected from avoidable harm because clear, comprehensive, person-centred and up-to-date risk assessments were in place, which staff followed closely. Systems and processes to audit and check the safety of both services were in place, and any outstanding actions and/or lessons learned were followed up and embedded into staff practice. Staff had been recruited safely and were supported to receive the necessary training and development for their role, resulting in a competent and confident workforce. Staff had undergone safeguarding training and put this into practice by demonstrating a good knowledge of which types of concerns needed reporting. Medicines practice was safe, and staff worked closely with external health professionals to ensure people received appropriate and timely care from various teams when they needed it. We found sufficient staff on duty in both services throughout our inspection which meant that people did not have to wait for care. Staff took time to get to know people, and they understood the need to obtain consent or make decisions in a person’s best interests should they lack capacity. The provider had systems and processes in place to understand the diverse health and care needs of people in their care. Staff told us how much they enjoyed working at the service and that they felt fully supported by the management team who were approachable, proactive and listened.
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Great Prospects Care Ltd received an overall rating of Requires Improvement at its first CQC inspection, driven by breaches of Regulation 17 due to incomplete risk assessments and inaccurate care records, despite staff knowing people well. The service performed well across effective, caring and responsive domains, with people reporting high satisfaction, consistent staffing, safe medicines management and good multi-agency working.
Concerns (4)
criticalCare planning: “one person was at risk of skin breakdown. There was no guidance in place for staff to follow to inform them what to do if the person's skin became sore or red”
criticalRecord keeping: “The provider failed to maintain accurate records in respect of each service user. This was a breach of Regulation 17 of the Health and Social Care Act 2008”
criticalGovernance: “The provider failed to monitor and mitigate the risks relating to the health, safety and welfare of service users. This was a breach of Regulation 17”
moderateCare planning: “person's care plan did not contain manual handling guidance for staff. There was no falls risk assessment to advise staff how to support them, and no skin integrity care plan.”
Strengths
· People received their medicines as prescribed and MAR sheets were clear, fully completed and reviewed monthly.
· Staff demonstrated good knowledge of safeguarding and whistleblowing procedures.
· Sufficient staffing levels maintained with no missed calls reported by relatives.
· Staff received comprehensive induction, regular supervision and competency checks.
· People felt treated with dignity and respect; staff knew people well and were kind and considerate.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to meet people's needs, preferences, interests and give them choice and controlGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Planning and promoting person-centred, high-quality care and support with openness; duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; Working in partnership with othersGood